scholarly journals Medical and Mental Health Comorbidities Among Minority Racial/Ethnic Groups in the United States

Author(s):  
Naheed Ahmed ◽  
C. Andrew Conway

Objective. To examine the prevalence of and the association between comorbid disorders and race/ethnicity in the United States. Methods. Using cross-sectional data from the 2012 National Behavioral Risk Factor Surveillance System [N=45,207,844], we examined comorbidity of psychological distress with self-reported diagnosis of diabetes, angina, and with history of heart attack and stroke. Logistic regression was used to examine between group differences by race/ethnicity. Results. Unadjusted results indicate that American Indian [OR 4.01, 95%CI: 1.78, 9.04] and Hispanic [OR 1.55, 95%CI: 1.04, 2.33] participants were more likely to have psychological distress and history of heart attack in comparison to Whites. American Indians were more likely to have psychological distress with angina [OR 3.82, 95%CI: 1.92, 7.63], and with history of stroke [OR 4.25, 95%CI: 2.16-8.26] in unadjusted results when compared to White participants. Conclusions. Our results suggest that racial/ethnic minority groups are more likely to suffer from comorbid mental health and medical conditions, which may be a result of stress arising from discrimination and historical oppression of these populations.

2017 ◽  
Vol 20 (6) ◽  
pp. 707-713 ◽  
Author(s):  
Michael J Zvolensky ◽  
Charles Jardin ◽  
Melanie M Wall ◽  
Misato Gbedemah ◽  
Deborah Hasin ◽  
...  

Abstract Introduction Decline in smoking in the United States has slowed over the past 25 years. Mental health problems are common among smokers, and may be an impediment to quitting and remaining abstinent. The study investigated the relationship between serious (past-30-day) psychological distress (SPD) and smoking, estimated trends in the prevalence of SPD among current, former, and never smokers in the United States from 2008 to 2014, and investigated whether heterogeneity in these trends varied by sociodemographic characteristics. Methods Data were drawn from the National Household Survey on Drug Use (NSDUH), an annual cross-sectional study of persons ages 12 and over (N = 270 227). SPD and smoking in the past 30 days were examined using logistic regression models among adults 18 and older. The prevalence of SPD was examined annually among current, former, and never smokers from 2008 to 2014. Results SPD increased among smokers in the United States from 2008 to 2014. An increase in SPD was more rapid among non-daily smokers than daily smokers. The prevalence of SPD was higher among younger smokers, those with less formal education and lower annual family income and higher among current smokers than former and never smokers. The relationships between SPD and smoking were stronger among smokers with higher education levels and annual family income. Conclusions Our findings suggest an increase in SPD among smokers over time and that as smoking has declined, those with SPD are comprising a greater proportion of the remaining smokers. Results suggest that mental health must be integrated into mainstream tobacco control efforts. Implications The greater prevalence and increasing rate of Serious Psychological Distress among smokers, relative to former- and never-smokers, from 2008 to 2014 provides support that the greater mental health burden among smokers may be contributing to the slowed reduction in smoking prevalence in the United States. In addition, relationships between SPD and smoking were consistently stronger among smokers with higher levels of education and annual family income. Such results suggest the necessity of incorporating mental health treatments in tobacco use reduction efforts.


2020 ◽  
Author(s):  
Jamila K Stockman ◽  
Brittany A Wood ◽  
Katherine M Anderson

BACKGROUND In the United States, racial and ethnic minorities are disproportionately affected by COVID-19, with persistent social and structural factors contributing to these disparities. At the intersection of race/ethnicity and gender, women of color may be disadvantaged in terms of COVID-19 outcomes due to their role as essential workers, their higher prevalence of pre-existing conditions, their increased stress and anxiety from the loss of wages and caregiving, and domestic violence. OBJECTIVE The purpose of this study is to examine racial and ethnic differences in the prevalence of COVID-19 outcomes, stressors, fear, and prevention behaviors among adult women residing in the United States. METHODS Between May and June 2020, women were recruited into the Capturing Women’s Experiences in Outbreak and Pandemic Environments (COPE) Study, a web-based cross-sectional study, using advertisements on Facebook; 491 eligible women completed a self-administered internet-based cross-sectional survey. Descriptive statistics were used to examine racial and ethnic differences (White; Asian; Native Hawaiian or other Pacific Islander; Black; Hispanic, Latina, or Spanish Origin; American Indian or Alaskan Native; multiracial or some other race, ethnicity, or origin) on COVID-19 outcomes, stressors, fear, and prevention behaviors. RESULTS Among our sample of women, 16% (73/470) reported COVID-19 symptoms, 22% (18/82) were concerned about possible exposure from the people they knew who tested positive for COVID-19, and 51.4% (227/442) knew where to get tested; yet, only 5.8% (27/469) had been tested. Racial/ethnic differences were observed, with racial/ethnic minority women being less likely to know where to get tested. Significant differences in race/ethnicity were observed for select stressors (food insecurity, not enough money, homeschooling children, unable to have a doctor or telemedicine appointment) and prevention behaviors (handwashing with soap, self-isolation if sick, public glove use, not leaving home for any activities). Although no racial/ethnic differences emerged from the Fear of COVID-19 Scale, significant racial/ethnic differences were observed for some of the individual scale items (eg, being afraid of getting COVID-19, sleep loss, and heart racing due to worrying about COVID-19). CONCLUSIONS The low prevalence of COVID-19 testing and knowledge of where to get tested indicate a critical need to expand testing for women in the United States, particularly among racial/ethnic minority women. Although the overall prevalence of engagement in prevention behaviors was high, targeted education and promotion of prevention activities are warranted in communities of color, particularly with consideration for stressors and adverse mental health.


Author(s):  
Jay J. Xu ◽  
Jarvis T. Chen ◽  
Thomas R. Belin ◽  
Ronald S. Brookmeyer ◽  
Marc A. Suchard ◽  
...  

The coronavirus disease 2019 (COVID-19) epidemic in the United States has disproportionately impacted communities of color across the country. Focusing on COVID-19-attributable mortality, we expand upon a national comparative analysis of years of potential life lost (YPLL) attributable to COVID-19 by race/ethnicity (Bassett et al., 2020), estimating percentages of total YPLL for non-Hispanic Whites, non-Hispanic Blacks, Hispanics, non-Hispanic Asians, and non-Hispanic American Indian or Alaska Natives, contrasting them with their respective percent population shares, as well as age-adjusted YPLL rate ratios—anchoring comparisons to non-Hispanic Whites—in each of 45 states and the District of Columbia using data from the National Center for Health Statistics as of 30 December 2020. Using a novel Monte Carlo simulation procedure to perform estimation, our results reveal substantial racial/ethnic disparities in COVID-19-attributable YPLL across states, with a prevailing pattern of non-Hispanic Blacks and Hispanics experiencing disproportionately high and non-Hispanic Whites experiencing disproportionately low COVID-19-attributable YPLL. Furthermore, estimated disparities are generally more pronounced when measuring mortality in terms of YPLL compared to death counts, reflecting the greater intensity of the disparities at younger ages. We also find substantial state-to-state variability in the magnitudes of the estimated racial/ethnic disparities, suggesting that they are driven in large part by social determinants of health whose degree of association with race/ethnicity varies by state.


2021 ◽  
pp. 103237322110581
Author(s):  
Sandra Gates ◽  
Megan Burke ◽  
John Humphreys

Little is known about the contributions of African-American slaves in the histories of various business domains, including accounting. Some authors attribute this scholarly silence to ideological motives due to race-ethnicity and bigotry. Others note that this paucity reflects not only a lack of data but also an inability to adequately approach the contributions of minorities to the accounting profession. Consequently, there are hidden voices in accounting history that should be explored. One of those voices belongs to Benjamin Thornton Montgomery, a Southern slave who became a plantation manager and owner. Observing Montgomery’s practices through the unique historical lens of the ante-bellum period of the United States, we argue that he should also be acknowledged for his responsibilities as an accountant. Accordingly, we use an analytically structured narrative process to examine the compelling case of Ben Montgomery to inform a more accurate and balanced historical foundation of accounting practice in America.


2021 ◽  
Author(s):  
Berkeley Franz ◽  
Adrienne Milner ◽  
Jomills H. Braddock

Abstract Background: Anti-black and anti-Hispanic attitudes in the U.S. must be included in efforts to understand resistance to public health measures, such as mask wearing, during the COVID-19 pandemic. Focusing on the structural and individual context of racism will enable us to improve public health and better prepare for future public health challenges. The purpose of this study was to determine the relationship between mask usage, racial segregation, and racial disparities in COVID-19 deaths.Methods: We used linear regression to assess whether the racial/ethnic composition of deaths and residential segregation predicted Americans’ decisions to wear masks in July 2020. Results: After controlling for mask mandates, mask usage increased when the White death rates relative to Black and Hispanic rates increased. Conclusions: Mask wearing may be shaped by an insensitivity to Black and Hispanic deaths and a corresponding unwillingness to engage in health protective behaviors. The broader history of systemic racism and residential segregation may also explain why white Americans do not wear masks or perceive themselves to be at risk when communities of color are disproportionately affected by COVID-19.


Author(s):  
Matthew D. Moore ◽  
Anne E. Brisendine ◽  
Martha S. Wingate

Objective This study was aimed to examine differences in infant mortality outcomes across maternal age subgroups less than 20 years in the United States with a specific focus on racial and ethnic disparities. Study Design Using National Center for Health Statistics cohort-linked live birth–infant death files (2009-2013) in this cross-sectional study, we calculated descriptive statistics by age (<15, 15–17, and 18–19 years) and racial/ethnic subgroups (non-Hispanic white [NHW], non-Hispanic black [NHB], and Hispanic) for infant, neonatal, and postneonatal mortality. Adjusted odds ratios (aOR) were calculated by race/ethnicity and age. Preterm birth and other maternal characteristics were included as covariates. Results Disparities were greatest for mothers <15 and NHB mothers. The risk of infant mortality among mothers <15 years compared to 18 to 19 years was higher regardless of race/ethnicity (NHW: aOR = 1.40, 95% confidence interval [CI]: 1.06–1.85; NHB: aOR = 1.28, 95% CI: 1.04–1.56; Hispanic: aOR = 1.36, 95%CI: 1.07–1.74). Compared to NHW mothers, NHB mothers had a consistently higher risk of infant mortality (15–17 years: aOR = 1.12, 95% CI: 1.03–1.21; 18–19 years: aOR = 1.21, 95% CI: 1.15–1.27), while Hispanic mothers had a consistently lower risk (15–17 years: aOR = 0.72, 95% CI: 0.66–0.78; 18–19 years: aOR = 0.74, 95% CI: 0.70–0.78). Adjusting for preterm birth had a greater influence than maternal characteristics on observed group differences in mortality. For neonatal and postneonatal mortality, patterns of disparities based on age and race/ethnicity differed from those of overall infant mortality. Conclusion Although infants born to younger mothers were at increased risk of mortality, variations by race/ethnicity and timing of death existed. When adjusted for preterm birth, differences in risk across age subgroups declined and, for some racial/ethnic groups, disappeared. Key Points


2019 ◽  
Vol 33 (9) ◽  
pp. 1058-1067 ◽  
Author(s):  
James D Sexton ◽  
Michael S Crawford ◽  
Noah W Sweat ◽  
Allyson Varley ◽  
Emma E Green ◽  
...  

Background: Novel psychedelics approximate classic psychedelics, but unlike classic psychedelics, novel psychedelics have been used by humans for a shorter period of time, with fewer data available on these substances. Aims: The purpose of this study was to determine the prevalence of novel psychedelic use and the associations of novel psychedelic use with mental health outcomes. Methods: We estimated the prevalence of self-reported, write-in lifetime novel psychedelic use and evaluated the associations of novel psychedelic use with psychosocial characteristics, past month psychological distress, and past year suicidality among adult respondents pooled from years 2008–2016 of the National Survey on Drug Use and Health (weighted n=234,914,788). Results: A fraction (weighted n=273,720; 0.12%) reported lifetime novel psychedelic use. This cohort tended to be younger, male, and White, have greater educational attainment but less income, be more likely to have never been married, engage in self-reported risky behavior, and report lifetime illicit use of other drugs, particularly classic psychedelics (96.9%). (2-(4-Bromo-2,5-dimethoxyphenyl)ethanamine) (2C-B) (30.01%), (2,5-dimethoxy-4-iodophenethylamine) (2C-I) (23.9%), and (1-(2,5-dimethoxy-4-ethylphenyl)-2-aminoethane) (2C-E) (14.8%) accounted for the majority of lifetime novel psychedelic use. Although lifetime novel psychedelic use was not associated with psychological distress or suicidality compared to no lifetime novel psychedelic use or classic psychedelic use, relative to lifetime use of classic psychedelics but not novel psychedelics, lifetime novel psychedelic use was associated with a greater likelihood of past year suicidal thinking (adjusted Odds Ratio (aOR)=1.4 (1.1–1.9)) and past year suicidal planning (aOR=1.6 (1.1–2.4)). Conclusion: Novel psychedelics may differ from classic psychedelics in meaningful ways, though additional, directed research is needed.


2020 ◽  
pp. 088626052094372
Author(s):  
Penelope K. Morrison ◽  
Chelsea Pallatino ◽  
Rachel A. Fusco ◽  
Tanya Kenkre ◽  
Judy Chang ◽  
...  

Intimate partner homicide (IPH) is a leading cause of maternal mortality in the United States. However, very little information exists as to the circumstantial factors associated with IPH during pregnancy. We conducted a descriptive study of the demographic characteristics, psychosocial service engagement, and crises experiences (i.e., life and relationship stressors) among pregnant and nonpregnant victims to understand what differences, if any, exist in their risk profile for IPH. Data from the Centers for Disease Control and Prevention’s National Violent Death Reporting System (NVDRS) were used for this study. The NVDRS is a national opt-in tracking system of all violent deaths in the United States. Pregnant victims ( N = 293) were significantly more likely to be 5 years younger than nonpregnant victims, African American, and never married. Pregnant victims were more likely to be seen in the emergency room following the fatal incident. Nonpregnant victims ( N = 2,089) were significantly more likely to have suspected alcohol use at the time of their death. In strictly proportional terms, we also observed higher rates of mental health problems, a history of mental health treatment, and a reported history of intimate partner violence (IPV), crisis, or family problems among nonpregnant victims. A wider range of IPH-related risk factors (e.g. substance abuse) need to be included IPV assessments. Future studies should seek to develop effective interventions to prevent IPH, particularly among reproductive aged women.


CNS Spectrums ◽  
2020 ◽  
Vol 25 (5) ◽  
pp. 638-650 ◽  
Author(s):  
Joel A. Dvoskin ◽  
James L. Knoll ◽  
Mollie Silva

This article traces the history of the way in which mental disorders were viewed and treated, from before the birth of Christ to the present day. Special attention is paid to the process of deinstitutionalization in the United States and the failure to create an adequately robust community mental health system to care for the people who, in a previous era, might have experienced lifelong hospitalization. As a result, far too many people with serious mental illnesses are living in jails and prisons that are ill-suited and unprepared to meet their needs.


2020 ◽  
Vol 4 (5) ◽  
Author(s):  
Jingxuan Zhao ◽  
Kimberly D Miller ◽  
Farhad Islami ◽  
Zhiyuan Zheng ◽  
Xuesong Han ◽  
...  

Abstract Background Little is known about disparities in economic burden due to premature cancer deaths by race or ethnicity in the United States. This study aimed to compare person-years of life lost (PYLLs) and lost earnings due to premature cancer deaths by race/ethnicity. Methods PYLLs were calculated using recent national cancer death and life expectancy data. PYLLs were combined with annual median earnings to generate lost earnings. We compared PYLLs and lost earnings among individuals who died at age 16-84 years due to cancer by racial/ethnic groups (non-Hispanic [NH] White, NH Black, NH Asian or Pacific Islander, and Hispanic). Results In 2015, PYLLs due to all premature cancer deaths were 6 512 810 for NH Whites, 1 196 709 for NH Blacks, 279 721 for NH Asian or Pacific Islanders, and 665 968 for Hispanics, translating to age-standardized lost earning rates (per 100 000 person-years) of $34.9 million, $43.5 million, $22.2 million, and $24.5 million, respectively. NH Blacks had higher age-standardized PYLL and lost earning rates than NH Whites for 13 of 19 selected cancer sites. If age-specific PYLL and lost earning rates for NH Blacks were the same as those of NH Whites, 241 334 PYLLs and $3.2 billion lost earnings (22.6% of the total lost earnings among NH Blacks) would have been avoided. Disparities were also observed for average PYLLs and lost earnings per cancer death for all cancers combined and 18 of 19 cancer sites. Conclusions Improving equal access to effective cancer prevention, screening, and treatment will be important in reducing the disproportional economic burden associated with racial/ethnic disparities.


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